Mind, Behavior & Global Health

Image from: www.abc.net.au/foreign/images/russiabeerboys.jpg

“All that we are is the result of what we have thought. The secret of health for both mind and body is not to mourn for the past, worry about the future,or anticipate troubles, but to live in the present moment wisely and earnestly.” -- The Buddha



The most difficult thing to do, for me at least, is to be present in the moment, at all times. Analysis of the past, worries and concern for the future, planning etc. etc. seem to always take precedence over the present. Meditation and yoga have helped me tremendously in "being in the moment," but it has yet to become intuitive and continues to be and perhaps will always be a practice.

In session VI of class we discussed the mind, behavior, and global health. Our case study discussion as presented very effectively by Jennifer and Ivette focused on the premature death of Eastern European and Russian men due to binge drinking of vodka and other hard liquors in the post-Soviet era. While vodka has been a mainstay of Russian and Soviet society for a very long time, Russia is a very cold country after all, alcoholism has been increasing tremendously following the collapse of the Soviet Union.
This development is not surprising, considering the tremendous socio-economic changes that have taken place in Russia since the collapse. Alcohol has for thousands of years been produced and consumed by different cultures and used as a means of escape from and a way to cope with reality. Someone mentioned in class that it is in the best interest of the Russian government to have people in a drunken stupor and therefore incapable of challenges government policy. This statement rings true and is characteristic of previous Russian and Soviet government behavior.

Since the beginning of the 20th Century, starting with the Bolsheviks, and again in the 1950's, 1970's and again in the 1980's under Mikhail Gorbachev, Russia has "tried" to institute prohibition against vodka consumption, sales, and marketing, however, they might have learned a lesson from the United States in that prohibition does not work. Nevertheless, even if vodka or other spirits are not readily available in the marketplace, people will illegally distill their own homemade brews, which may in fact be more dangerous for their health and much more difficult to control and regulate.
So how can the Russians reduce the mortality and morbidity burden attributed to alcohol? It's a complicated task and requires social norms change regarding the acceptability of male binge drinking in the culture in addition the implementation of evidence-based alcohol treatment programs. However, the biggest reason why alcoholism has sky-rocketed in Russia after the collapse of the Soviet regime is because of the desperation and disenfranchisement that these men feel in the new economic reality, in which they can no longer depend on the state for economic well being. Therefore, unless Russia institutes major economic and social reforms to make more jobs and more social services available to all sectors of society, alcoholism will continue to plague the nation.

Educate Women to Make the World a Better Place

Image from UK Department for International Development

In session V, our strategic overview of Food Security, Rural and Agriculture Development as expressed in the Millennium Development Goals

touched upon the importance of the Education of Women, a topic very near and dear to my heart. The article, Agriculture, Food Security, Nutrition and the Millennium Development Goals by Joachim von Braun et. al discusses the importance of educating and empowering women to help achieve several of the MDGs, including enhancements in agricultural productivity and rural development in addition to improving maternal and child health, reducing child mortality and decreasing malnutrition among children. Of course, none of these occur in a vacuum, there are other factors involved in achieving these goals, including policy and social norms change, however, as Dr. Shahi mentioned in class, educating women goes a long way in reducing a lot of the problems that challenge the global community today.

I come from a male dominated culture, which places very little value on the education of women and emphasizes the role of women in the domestic arena. In addition to that I was born and spent the first 12 years of my life in the Soviet Union and while primary and secondary education was provided by the state, only the elite and wealthy had access and enough money and connections to bypass the corrupt college admissions process. I'm very fortunate to have had to opportunity to relocate to this country, where for the most part, women have as much access to education as men do. Despite prevailing chauvinist attitudes about the education of women in this country, including those of ex Harvard President Larry Summers (whether the comments were misconstrued and taken out of context is a separate discussion), even Harvard is taking steps to remedy the situation in naming their first female President since its founding in 1636.

The Population Council and the Rockefeller Foundation
list the benefits to society of educating women, including increased economic productivity, improvements in health, delayed age at marriage, lower fertility, increased political participation, and generally more effective investments in the next generation.
"While there are many other possible interventions to achieve these social goods, girls' education is the only one which impacts all of them simultaneously."

So while we are raking our brains looking for solutions and interventions to help solve some of the most difficult ills that plague our society, we must not overlook the most profound action we can take to advance society, eradicate hunger and poverty, and reduce child malnutrition etc.

Non-Communicable Disease: The Bane of Global Health

Child Obesity in China, you can thank KFC, finger-licking disgusting.

Week 4's class was rather interesting, because we often dismiss chronic disease as the affliction of old age. My grandfather died of lung cancer but he had a long life, full of struggle as he survived the Armenian Genocide, fought the Nazis as a partisan in Greece, but also happiness as he had lots of grandchildren. He was also a lifetimes smoker.
This article was an eye opener as it talked about people in their 30's in Russia and India dying of heart attacks. From what we've discussed in class, the videos and articles we've read so far, it's clear that in the last couple of decades, along with global trade and exchange of information and culture, we've also exported the American diet and lifestyle and with it our cardiovascular disease. Someone in class mentioned a KFC in every corner in China. We're robbing these people fo their culture and killing them at the same time. According to "Race Against Time: The Challenge of Cardiovascular Disease in Developing Countries"
Report

In lower and middle income countries, cardiovascular disease morbidity and mortality is occurring at an alarmingly younger age, often during the most productive years of an individual's life, not only wrenching them away from their families, leaving widows in poverty, but also taking young people of out of the economy, thereby threatening its expansion.

Non-Communicable Diseases result in more deaths and account for more years of healthy life lost than communicable disease, yet there's little aid available for prevention efforts. Cardiovascular disease (CVD,including heart disease, diabetes, and obesity) is the cause of 30 percent of all deaths globally and 27 percent of deaths in low income countries, compared to HIV/AIDS, tuberculosis and malaria, which account to 10% of all global deaths and 11% of death, yet there is little aid going to prevent and treat CVD globally.
Johns Hopkins

Prevention and treatment programs for CVD are relatively low cost-per-life saved and disability prevented. The risk factors associated with CVD, including high fat diets, lack of exercise, smoking, and obesity are preventable and modifiable and there is no reason why the global health community should not emphasize prevention efforts on CVD in addition to infectious disease.